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BMC Medicine

Yihua Bei, Li-Long Pan, Qiulian Zhou, Cuimei Zhao, Yuan Xie, Chengfei Wu, Xiangmin Meng, Huanyu Gu, Jiahong Xu, Lei Zhou, Joost P G Sluijter, Saumya Das, Birgitta Agerberth, Jia Sun, Junjie Xiao
BACKGROUND: Cathelicidins are a major group of natural antimicrobial peptides which play essential roles in regulating host defense and immunity. In addition to the antimicrobial and immunomodulatory activities, recent studies have reported the involvement of cathelicidins in cardiovascular diseases by regulating inflammatory response and microvascular dysfunction. However, the role of cathelicidins in myocardial apoptosis upon cardiac ischemia/reperfusion (I/R) injury remains largely unknown...
February 20, 2019: BMC Medicine
Kirsten Evenblij, H Roeline W Pasman, Agnes van der Heide, Trynke Hoekstra, Bregje D Onwuteaka-Philipsen
BACKGROUND: Recently, euthanasia and assisted suicide (EAS) in patients with psychiatric disorders, dementia, or an accumulation of health problems has taken a prominent place in the public debate. However, limited is known about this practice. The purpose of this study was threefold: to estimate the frequency of requesting and receiving EAS among people with (also) a psychiatric disorder, dementia, or an accumulation of health problems; to explore reasons for physicians to grant or refuse a request; and to describe differences in characteristics, including the presence of psychiatric disorders, dementia, and accumulation of health problems, between patients who did and did not request EAS and between patients whose request was or was not granted...
February 19, 2019: BMC Medicine
Sophie E Moore, Anthony J C Fulford, Fatou Sosseh, Patrick Nshe, Momodou K Darboe, Andrew M Prentice
BACKGROUND: Thymic size in early infancy predicts subsequent survival in low-income settings. The human thymus develops from early gestation, is most active in early life and is highly sensitive to malnutrition. Our objective was to test whether thymic size in infancy could be increased by maternal and/or infant nutritional supplementation. METHODS: The Early Nutrition and Immune Development (ENID) Trial was a randomized 2 × 2 × 2 factorial, partially blinded trial of nutritional supplementation conducted in rural Gambia, West Africa...
February 18, 2019: BMC Medicine
Michael Berk, Alyna Turner, Gin S Malhi, Chee H Ng, Susan M Cotton, Seetal Dodd, Yuval Samuni, Michelle Tanious, Claire McAulay, Nathan Dowling, Jerome Sarris, Lauren Owen, Astrid Waterdrinker, Deidre Smith, Olivia M Dean
The original article [1] contained two minor errors.
February 17, 2019: BMC Medicine
Deepa Rao, Ahmed Elshafei, Minh Nguyen, Mark L Hatzenbuehler, Sarah Frey, Vivian F Go
BACKGROUND: Researchers have long recognized that stigma is a global, multi-level phenomenon requiring intervention approaches that target multiple levels including individual, interpersonal, community, and structural levels. While existing interventions have produced modest reductions in stigma, their full reach and impact remain limited by a nearly exclusive focus targeting only one level of analysis. METHODS: We conducted the first systematic review of original research on multi-level stigma-reduction interventions...
February 15, 2019: BMC Medicine
Gretchen L Birbeck, Virginia Bond, Valerie Earnshaw, Musah Lumumba El-Nasoor
Health-related stigma remains a major barrier to improving health and well-being for vulnerable populations around the world. This collection on stigma research and global health emerged largely as a result of a 2017 meeting on the "The Science of Stigma Reduction" sponsored by the US National Institutes of Health (NIH). An overwhelming consensus at the meeting was reached. It was determined that for stigma research to advance further, particularly to achieve effective and scalable stigma reduction interventions, the discipline of stigma research must evolve beyond disease-specific investigations and frameworks and move toward more unified theories of stigma that transcend individual conditions...
February 15, 2019: BMC Medicine
Anne L Stangl, Valerie A Earnshaw, Carmen H Logie, Wim van Brakel, Leickness C Simbayi, Iman Barré, John F Dovidio
Stigma is a well-documented barrier to health seeking behavior, engagement in care and adherence to treatment across a range of health conditions globally. In order to halt the stigmatization process and mitigate the harmful consequences of health-related stigma (i.e. stigma associated with health conditions), it is critical to have an explicit theoretical framework to guide intervention development, measurement, research, and policy. Existing stigma frameworks typically focus on one health condition in isolation and often concentrate on the psychological pathways occurring among individuals...
February 15, 2019: BMC Medicine
Christopher G Kemp, Brooke A Jarrett, Churl-Su Kwon, Lanxin Song, Nathalie Jetté, Jaime C Sapag, Judith Bass, Laura Murray, Deepa Rao, Stefan Baral
BACKGROUND: Interventions to alleviate stigma are demonstrating effectiveness across a range of conditions, though few move beyond the pilot phase, especially in low- and middle-income countries (LMICs). Implementation science offers tools to study complex interventions, understand barriers to implementation, and generate evidence of affordability, scalability, and sustainability. Such evidence could be used to convince policy-makers and donors to invest in implementation. However, the utility of implementation research depends on its rigor and replicability...
February 15, 2019: BMC Medicine
Jeremy C Kane, Melissa A Elafros, Sarah M Murray, Ellen M H Mitchell, Jura L Augustinavicius, Sara Causevic, Stefan D Baral
BACKGROUND: Stigma is associated with health conditions that drive disease burden in low- and middle-income countries (LMICs), including HIV, tuberculosis, mental health problems, epilepsy, and substance use disorders. However, the literature discussing the relationship between stigma and health outcomes is largely fragmented within disease-specific siloes, thus limiting the identification of common moderators or mechanisms through which stigma potentiates adverse health outcomes as well as the development of broadly relevant stigma mitigation interventions...
February 15, 2019: BMC Medicine
Wim H van Brakel, Janine Cataldo, Sandeep Grover, Brandon A Kohrt, Laura Nyblade, Melissa Stockton, Edwin Wouters, Lawrence H Yang
BACKGROUND: Many health conditions perceived to be contagious, dangerous or incurable, or resulting in clearly visible signs, share a common attribute - an association with stigma and discrimination. While the etiology of stigma may differ between conditions and, sometimes, cultural settings, the manifestations and psychosocial consequences of stigma and discrimination are remarkably similar. However, the vast majority of studies measuring stigma or addressing stigma through interventions employ a disease-specific approach...
February 15, 2019: BMC Medicine
Janet M Turan, Melissa A Elafros, Carmen H Logie, Swagata Banik, Bulent Turan, Kaylee B Crockett, Bernice Pescosolido, Sarah M Murray
BACKGROUND: 'Intersectional stigma' is a concept that has emerged to characterize the convergence of multiple stigmatized identities within a person or group, and to address their joint effects on health and wellbeing. While enquiry into the intersections of race, class, and gender serves as the historical and theoretical basis for intersectional stigma, there is little consensus on how best to characterize and analyze intersectional stigma, or on how to design interventions to address this complex phenomenon...
February 15, 2019: BMC Medicine
Laurel Sprague, Rima Afifi, George Ayala, Musah Lumumba El-Nasoor
BACKGROUND: Participatory praxis is increasingly valued for the reliability, validity, and relevance of research results that it fosters. Participatory methods become an imperative in health-related stigma research, where the constitutive elements of stigma, healthcare settings, and research each operate on hierarchies that push those with less social power to the margins. DISCUSSION: Particularly for people who are stigmatized, participatory methods balance the scales of equity by restructuring power relationships...
February 15, 2019: BMC Medicine
Laura Nyblade, Melissa A Stockton, Kayla Giger, Virginia Bond, Maria L Ekstrand, Roger Mc Lean, Ellen M H Mitchell, La Ron E Nelson, Jaime C Sapag, Taweesap Siraprapasiri, Janet Turan, Edwin Wouters
Stigma in health facilities undermines diagnosis, treatment, and successful health outcomes. Addressing stigma is fundamental to delivering quality healthcare and achieving optimal health. This correspondence article seeks to assess how developments over the past 5 years have contributed to the state of programmatic knowledge-both approaches and methods-regarding interventions to reduce stigma in health facilities, and explores the potential to concurrently address multiple health condition stigmas. It is supported by findings from a systematic review of published articles indexed in PubMed, Psychinfo and Web of Science, and in the United States Agency for International Development's Development Experience Clearinghouse, which was conducted in February 2018 and restricted to the past 5 years...
February 15, 2019: BMC Medicine
Huiqin Yang, Alexis Llewellyn, Ruth Walker, Melissa Harden, Pedro Saramago, Susan Griffin, Mark Simmonds
BACKGROUND: High-throughput non-invasive prenatal testing (NIPT) for fetal Rhesus D (RhD) status could avoid unnecessary treatment with anti-D immunoglobulin for RhD-negative women found to be carrying an RhD-negative fetus. We aimed to assess the diagnostic accuracy of high-throughput NIPT for fetal RhD status in RhD-negative women not known to be sensitized to the RhD antigen, by performing a systematic review and meta-analysis. METHODS: Prospective cohort studies of high-throughput NIPT used to determine fetal RhD status were included...
February 14, 2019: BMC Medicine
Annie Haakenstad, Matthew Coates, Andrew Marx, Gene Bukhman, Stéphane Verguet
BACKGROUND: Financial risk protection (FRP) is a key objective of national health systems and a core pillar of universal health coverage (UHC). Yet, little is known about the disease-specific distribution of catastrophic health expenditure (CHE) at the national level. METHODS: Using the World Health Surveys (WHS) from 39 countries, we quantified CHE, or household health spending that surpasses 40% of capacity-to-pay by key disease areas. We restricted our analysis to households in which the respondent used health care in the last 30 days and categorized CHE into disease areas included as WHS response options: maternal and child health (MCH); high fever, severe diarrhea, or cough; heart disease; asthma; injury; surgery; and other...
February 13, 2019: BMC Medicine
Huichun Zhan
No abstract text is available yet for this article.
February 12, 2019: BMC Medicine
Nils Gutacker, Karen Bloor, Chris Bojke, Julian Archer, Kieran Walshe
BACKGROUND: In 2012, the UK introduced medical revalidation, whereby to retain their licence all doctors are required to show periodically that they are up to date and fit to practise medicine. Early reports suggested that some doctors found the process overly onerous and chose to leave practice. This study investigates the effect of medical revalidation on the rate at which consultants (senior hospital doctors) leave NHS practice, and assesses any differences between the performance of consultants who left or remained in practice before and after the introduction of revalidation...
February 11, 2019: BMC Medicine
Gail M Williams, Ian Douglas Riley, Riley H Hazard, Hafizur R Chowhury, Nurul Alam, Peter Kim Streafield, Veronica Tallo, Diozele Sanvictores, Marilla Lucero, Tim Adair, Alan D Lopez
BACKGROUND: Almost all countries without complete vital registration systems have data on deaths collected by hospitals. However, these data have not been widely used to estimate cause of death (COD) patterns in populations because only a non-representative fraction of people in these countries die in health facilities. Methods that can exploit hospital mortality statistics to reliably estimate community COD patterns are required to strengthen the evidence base for disease and injury control programs...
February 8, 2019: BMC Medicine
Rakhi Dandona, G Anil Kumar, Md Akbar, Debarshi Bhattacharya, Priya Nanda, Lalit Dandona
BACKGROUND: The India Newborn Action Plan (INAP) aims for < 10 stillbirths per 1000 births by 2030. A population-based understanding of risk factors for stillbirths compared with live births that could assist with reduction of stillbirths is not readily available for the Indian population. METHODS: Detailed interviews were conducted in a representative sample of all births between January and December 2016 from 182,486 households (96.2% participation) in 1657 clusters in the Indian state of Bihar...
February 7, 2019: BMC Medicine
Lina Zhang, Lulu Song, Bingqing Liu, Mingyang Wu, Lulin Wang, Bin Zhang, Chao Xiong, Wei Xia, Yuanyuan Li, Zhongqiang Cao, Youjie Wang, Shunqing Xu
BACKGROUND: Newborn telomere length (TL) is considered a potential marker for future disease and lifelong health, but few epidemiological studies have examined the determinants of TL in early life. The study aim was to investigate whether there is an association between prenatal cadmium exposure and relative cord blood TL in Chinese newborns. METHODS: Participants were 410 mother-newborn pairs drawn from a prospective birth cohort study conducted in Wuhan, China, between November 2013 and March 2015...
February 6, 2019: BMC Medicine
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